Conclusions: A departmental consensus list of common clinical presentations
and their respective differential diagnoses was compiled.

Take-home messages: This study represents the first step towards developing an
undergraduate clinical presentation-oriented Internal Medicine curriculum that
is tailor-made for South Africa's health milieu.

9BB/2

Critical analysis of the Endocrine and
Diabetes Module of the Core Medical Training curriculum

Background: The General Medical Council has defined the curriculum as a,
'Statement of the intended aims and objectives, content, experiences, outcome
and processes of a programme, including a description of the structure and
expected methods of learning, teaching, feedback and supervision.'

Summary of work: We analysed the existing Endocrine and Diabetes module of the
core medical training to see whether it satisfies the stated requirements of a
curriculum.

Summary of results: We found that the module had the desired elements of learner
centred approach delivered through e portfolio, competency based well-laid out
syllabus, link to suggested tools for assessments, but some aspects remain
unachieved like plans for adequate staffing, promotion of reflective and
autonomous thinking, tools for learning form practice, clinic letters, audit
projects and critical incident review. Specific to diabetes, in-patient
diabetes care, community diabetes and leadership training in diabetes service
organisation were not adequately represented in the curriculum. Professionalism
and virtuous practice of medicine were not explicitly mentioned in the
curriculum and no suggestions were mentioned as to how to assess them. Use of
online resources was not detailed. We recommend revising the existing curricula
to include these elements.

Conclusions: We recommend revising the current curriculum to include the
elements unachieved in the results and to integrate a partnership approach
between teachers and learners.

Take-home messages: The existing curriculum does satisfy the stated requirements of
a curriculum however to maximise the teaching of the trainees certain aspects
can be improved and we have made some recommendations.

Background: Patient-centered care is a fundamental clinical method
contributing towards the quality of healthcare. However, studies have shown a
decline in patient-centered behaviours/attitudes in medical students. The
influence of a hidden curriculum may underlie these results. The C3 Instrument
(questionnaire to characterize the patient-centeredness of a medical

school hidden curriculum), was
previously developed and validated in English and then adapted to the
Portuguese language.

Summary of work: This study aimed to characterize the patient-centeredness of the
hidden curriculum in the Faculty of Health Science - University of
Beira Interior (FCS-UBI) (Covilha-Portugal) using the C3 Instrument. It was
applied to medical students from the last 2 years. Responses
were analysed by applying descriptive and inferential tests.

Summary of results: The C3 Instrument was completed by 145 students, with a
response rate of 94%. The FCS-UBI students' C3 results were similar to the ones found
in USA medical schools.

Conclusions: FCS-UBI medical students seem to be exposed to a similar hidden
curriculum as the ones found in USA medical schools. A more detailed analysis
highlighted some points where intervention might modify or decrease the
negative impact of the hidden curriculum upon human and professional
development of medical students.

Take-home messages: The hidden curriculum might be the most powerful force shaping
medical students attitudes and behaviours. Knowing the hidden curriculum of a
medical school is crucial towards its development. Interventions might be
needed to modify/decrease the negative impact of the hidden curriculum upon
human and professional development of FCS-UBI medical students.

9BB/4

Stakeholders' perspectives about
Institutional culture and curriculum reform a decade after the Brazilian
Curricular Guidelines for the undergraduate medical course

Background: The Brazilian Guidelines were published in 2001. The goal was to
stimulate adjustment of the curriculum more adequately to prepare competent and
reflective doctors, able to answer to the health needs of the society, strengthening
the Brazilian Unified Health System.

Summary of work: An exploratory qualitative research was done to know the
advances made and the challenges faced by the medical schools during curriculum
change. We performed by phone semi-structured interviews with one student, one
professor and the Dean of eighteen public and private medical schools randomly
selected. Thematic content analysis was used. The study was approved by the
Ethics Board

(Brazil Platform,
CAAE:01376712.7.0000.5404).

Summary of results: Changes occurred in all the schools. However, the changes'
amplitude varied according to

ABSTRACT BOOK: SESSION 9 TUESDAY 27 AUGUST: 1600-1730

the institution's culture, leadership,
and adhesion to funding support through governmental project. We identified
three school cultures: traditional, adaptable and highly adaptable. The
participants of traditional schools reported few changes and high faculty
resistance. Those from adaptable schools reported that the process of change
was easier. The participants of highly adaptable schools mentioned that the
changes began even before 2001 and highlighted a "strong" leadership, and that the
stakeholders like to try new methods and are not afraid of changes. Conclusions: The
resistance of traditional schools' stakeholders may be caused by their
difficulty in handling the unpredictability and uncertainty inherent to
changes. It is easy to change the curriculum in adaptable schools. Perhaps, the
investment in building an adaptive culture in the traditional institutions
could facilitate the changes.

Take-home messages: Building an adaptive culture in the school can be a key to make
changes happen.

Background: Since 2004 ISMETT's nursing education group has had a training program for
newly hired nurses. ISMETT (The Mediterranean Institute for Transplantation and
Advanced Specialized Therapies), founded in 1998, is an 80-bed
hospital in Palermo, Italy. Summary
of work: The nursing
education group consists of six nurse educators, each assigned to a specific
operational unit. Our training schedule includes four weeks of theoretical
training and six courses on emergency clinical simulation, punctuated by
observation within the operating units, and followed by a one-month period of
mentoring with a nurse preceptor. The main contents of training include the
electronic medical record, lectures on ECG, hemodynamics, infection control,
medication, unit-specific procedures, and basic and advanced management of
emergencies.

Summary of results: From 2004 to 2012, we trained 369 nurses, and assessed the results from both a theoretical and
practical standpoint, using multiple-choice tests, practical debriefing in a
simulation environment, and skill evaluation checklists.

Conclusions: At present we have a form of structured training, with attention
to content and training objectives, and punctuated by constant assessments in
the course of learning, designed to optimize timing and results of educational
intervention. The achievement of skills is encouraged by an annual assessment
that assigns to the nurses a different skill level (basic-

intermediate-advanced), closely
related to the professional growth of each nurse. Take-home messages: Professional
growth related to nursing education must always be based on the rigor of
well-structured training and, at the same time, openness to technological
innovations and new training needs.

9BB/6

A comparison of the performance of
students from life sciences vs medicine and its allied specialties in an
objective test on regenerative medicine: the lessons learnt for curriculum
development

Background: Regenerative Medicine (RM) is a growing paradigm in biology in
which the constant interaction and communication between basic scientists and
clinicians is indispensable. In this study we have analysed the performance of
students studying under­graduate and post-graduate courses in the fields of
medical and its allied specialties. Summary
of work: We have analysed
the performance in terms of scores in an objective multiple choice quiz of
students studying graduate and post-graduate courses in the above mentioned
fields in a quiz on stem cells and

RM.

Summary of results: The results revealed that the average scores of students
studying medicine and its allied specialties were high compared to students
studying life science courses. A two sample t-test revealed statistical
significance in the scores (P value = 0.04; P <0.05) between students of these two categories. Students
from medicine and its allied specialties won the quiz three times and even
students studying the exclusive RM course won the quiz twice. Students from the
field of life sciences did not win the quiz even once.

Conclusions: Exposure and information gained on concepts in Regenerative
Medicine is less among students studying life science courses in higher
education compared to students studying courses in medicine and other allied
specialties. Take-home messages:
This upcoming field of medicine should
be included in the curriculum of the science students too.

9BB/7

The influence of preceptor power style
on learner empowerment: a measure of the hidden curriculum in clinical learning
environments

Background: Clinical learning occurs in environments wherein students may
compromise their values in order to be perceived positively by supervisors.
Preceptor influence represents a type of social power, an important determinant
of an individual's sense of personal empowerment in any environment. Summary of work: Early (n = 77) and late (n =79) stage clerks from
six disciplines completed modified Teacher Power Use (TPUS) and Learner
Empowerment (LEM) scales for their primary preceptor- identified simply as
either staff physician or resident- and their personal senses of empowerment,
respectively. TPUS and LEM outcomes were subjected to correlational analyses as
well as independent 2 cohort by 2 preceptor by 6 discipline analyses of variance. Summary of results: Learner
perception of empowerment was correlated positively (r = .66, p < .05) with
pro-social preceptor power use and negatively (r = -.32, p < .05) with
coercive power use. Furthermore, coercive power use was perceived more strongly
by students with a resident as the primary supervisor (F (4, 572) = 4.7, p < .05).

Conclusions: Preceptor power use impacts learners' sense of empowerment in
clinical learning environments. Rotations where residents provide the majority
of clerk supervision are more likely to subject learners to coercive power
environments, which may in turn contribute negatively to their socialization
into the profession.

Take-home messages: This study highlights the relationship between power use and
perception of empowerment and uses the hidden curriculum framework to discuss
the way cultural and/or organizational influences can potentially impact
learners' values and professional behaviour.

9BB/8

Conceptions of teachers from a medical
school of a Federal University in Brazil about the relationship between medical
work, medical education and social demands

Francisco Jose Passos Soares(Federal University
of

Alagoas, Faculty of Medicine, Av.
Eraldo Lins Cavalcante,

698, Murilopolis,
Maceio 57045-430, Brazil)

Marilia Bulhoes Calheiros (Federal
University of Alagoas,

Faculty of Medicine, Maceio, Brazil)

Mariana Percia Name de Souza Franco
(Federal

University of Alagoas, Faculty of
Medicine, Maceio,

Brazil)

Background: The curriculum guidelines for Brazilian medical courses provided
changes that guide for the training of generalist doctors with a critical and
humanist profile. Although curricular change in medical school of the Federal
University of Alagoas started in 2006, we still can observe dissatisfaction
from teachers with a curriculum oriented towards training of generalists
doctors with emphasis on primary and secondary levels of health care. Summary of work: This
paper aims to observe how medical teachers from the Federal University of
Alagoas

perceive and articulate concepts
related to medical work, medical education and social demands. This is a
qualitative study of content analysis from responses stimulated by standardized
questions, which were recorded and later transcribed. We interviewed 23
teachers in a sample of convenience, to the point of saturation.

Summary of results: 100% of teachers responded that medical work does not meet
current social demands, pointing out deficiencies found in primary care. 50% said that medical
education is oriented towards current requirements for medical work,
emphasizing the curriculum's goal to train generalists focused on the need of
the population, despite the fact that the market leads doctors for speciality.
The remaining 50% responded negatively to the same question, saying that there
is still a gap between theory and practice and that medical education should
not only be focused on primary care.

Conclusions: Teachers consider that medical work is undervalued and in
disagreement with social demands; also they consider that the job market
competes and supersedes the current medical education oriented towards primary
and secondary care.

9BB/9

Societal commitment, competitiveness
and public health system: views and perceptions of the Chilean medical students
and graduates

Background:180 years since its foundation, during 2013 the School of
Medicine of University of Chile, pursuing social accountability with academic
excellence, is changing its curriculum and is selecting and supporting socially
disadvantaged medical students. This qualitative study investigated medical
interns' and graduates' self-image, societal commitment and personal
aspirations concerning their professional development, as a baseline providing
inputs for these meaningful changes. Summary
of work: During 2012 medical
interns and five year graduates participated in a qualitative study using
"grounded theory" method, through 18 in-depth
interviews and 2 focus groups. The first part of this study was done with first
and fourth year medical students during 2011.

Summary of results: In spite of the ideals for social commitment that drive the
preference for our Medical School, students and graduates feel a loss of social
engagement in their medical practice. Related to the desire to become specialists
instead of general practitioners, with individual gain over social impact,

ABSTRACT BOOK: SESSION 9 TUESDAY 27 AUGUST: 1600-1730

they strengthen competitiveness as
driving their behavior. On their view, this is also a result of the conditions
of the public health system in Chile. Conclusions:
Competitiveness during the career and
the lack of strong public policies encouraging social commitment of medical
doctors are seen as obstacles to fulfilling social accountability, with the
loss of social engagement in the medical practice. Take-home messages: The
School of Medicine has a challenge for the new curriculum but also has to
strengthen partnership with stakeholders (public policy makers) as a socially
accountable medical school.

Background: Based on national demand, the goal of Indonesian Medical
Education is to produce primary health care physicians. Competencies
requirements that should be achieved by the graduates are decided respecting
the community healthcare needs. Considering factual problems and the health
challenges, in the year 2005 the curriculum committee appreciated the need of
updating the curriculum with additional content concerning emerging and
re-emerging disease and mass disaster, as primary care physicians will play a
role as healthcare providers and leaders of healthcare teams in meeting these
potential healthcare challenges. Summary
of work: A learning strategy
was arranged to facilitate the students obtaining a theoretical base and
professional skills. In the early semester the theoretical base is discussed
through interactive lectures facilitated by experts of medical science,
communication and leadership, followed by problem based small group discussion,
doing a community survey to face the actual problems or field training in a
mass disaster block. In the clinical stage they stay one month in the primary
healthcare center to practice medical care, leadership and teamwork.

Summary of results: There are increasing numbers of student research projects that
relate to emerging and re-emerging disease, and likewise the number of students
that joined the social program for special health population or enrolled as
volunteers in a medical team for disaster.

Conclusions: Medical education should be designed to meet health needs. As
predicted, currently re-emerging disease and natural disaster become a
prominent health problem.

Take-home messages: Regularly updating the curriculum is necessary to make medical
education responsive and relevant to the health system.

Background: Despite hard work, leaders insist on making their own
bureaucratic decision without philosophical and scientific bases. Meanwhile,
there was a huge debate between health care and education leaders on how to
assure quality and theory-practice balance.

Summary of work: This work focused on investigation of the relationship between
quality and the most common philosophies and theories that were applied or
appropriate to be applied for nursing and applied medical education in United
Kingdom, United States and Saudi Arabia. It used a creative integrated research
model derived from the historical educational development research with
documentary analysis. Summary of results:
This study begins by deliberating on
the problems of the Saudi Arabian Nursing and Applied Medical Education and
Practice, mainly the debate between the Saudi nursing education and nursing
service regarding the quality of the graduate nurse students and the dilemma of
the gap between theory and practice. Reflection on experience throughout
studying the MA (Ed) courses and theses suggested that "the Western
philosophy and science of curriculum, teaching and learning may guide Saudi
Arabia towards a factual way to overcome these considerable problems and to
assure quality as well". After its investigation, compassion, the study
focused on 25 philosophical and scientific worldwide used models. Conclusions: After
using 'the related Islamic Ethical bases with Poppers' notions of conjectures
and refutations', to validate its results, the study endeavours to modify
Michigan's philosophy into a philosophy of fourteen theories as a base for
future developmental studies.

Take-home messages: To assure total quality of health, health care services and
planning and development of nationally applied medical education and curriculum,
we have to conduct more philosophical and scientific based research, starting
by preparing the ground for quality, philosophy and scientific theories based
teaching, learning and curriculum planning and development.

Background: Background: Patient safety is the one of the major goals in
healthcare. Srinagarind Hospital, Faculty of Medicine, Khon Kaen University is
a pioneer in the integration of patient safety and risk management in

ABSTRACT BOOK: SESSION 9 TUESDAY 27 AUGUST: 1600-1730

the medical curriculum. In 2008 the
Healthcare Accreditation Institute, Thailand, announced the Thai Patient Safety
Goal using S I M P L E strategy which is Safe Surgery, Infection Control,
Medication Safety, Patient Care Process, Line, Tube & Catheter, and
Emergency Response respectively. The understanding of patient safety by using S
I M P L E is very important for medical staff including medical students. Summary of work: Objectives:
1) to study the understanding 5th year medical students have in patient safety
following the S I M P L E strategy and 2) to study the degree of implementation of patient safety
strategy in real-life practice. Method: Descriptive study by using S I M P L E
questionnaire.